Direct download links of 000-N01 VCE at killexams.com

Rather than wasting period and money upon searching updated IBM B2B Integration Technical Mastery Test v1 queries, you should move forward and sign up on killexams.com. Download 100% free of charge dumps purchase complete 000-N01 braindumps version. Read plus pass the 000-N01 examination.

Exam Code: 000-N01 Practice test 2022 by Killexams.com team
IBM B2B Integration Technical Mastery Test v1
IBM Integration test success
Killexams : IBM Integration test success - BingNews https://killexams.com/pass4sure/exam-detail/000-N01 Search results Killexams : IBM Integration test success - BingNews https://killexams.com/pass4sure/exam-detail/000-N01 https://killexams.com/exam_list/IBM Killexams : Remy Mandon

Remy Mandon is the Director of Client Success and Worldwide Sales for IBM Information Integration and Governance Software. With more than 20 years of experience in the software industry, Remy has deep expertise in Data Integration, �Data Quality, Governance, Master Data and Entity relationship, as well as Data Masking and archiving.� Leveraging this experience, Remy helps IBM Clients successfully manage and secure all data across their Big Data and Analytics initiativesDedicated to client success, Remy leads a worldwide team committed to helping clients maximize their revenue opportunities while remaining fully compliant with regulatory requirements.� Remy also helps Big Data specialists across the globe to focus on the data integration and security imperatives of our clients.Remy joined IBM from Oracle in 2001. During his 15 years with IBM, he has held various sales positions in France, where he was the country leader for WebSphere Software. In 2014 Remy relocated to the United States to support the IBM General Manager of Worldwide Software Sales.Remy holds degrees from Universit� Paris Descartes in Economics and Sales and from London Metropolitan University in Business and Languages.�

Fri, 21 Apr 2017 21:03:00 -0500 en text/html https://www.accountingtoday.com/author/remy-mandon-im2001696
Killexams : Cybersecurity Bootcamp

Scholarships are available to those who qualify. There are three scholarship programs currently available. These will be awarded to a limited number of applicants meeting the following conditions: 1) United States citizens or permanent residents currently on unemployment and/or 2) from diverse populations/underrepresented backgrounds. If you apply and are found eligible for multiple, you may be able to receive the scholarships simultaneously, further reducing program costs, depending on availability.
Apply Here >

Training Grants for Unemployed and Under-Employed Workers:

The Cybersecurity Bootcamp is a training provider program on the New York State Eligible Training Provider List (ETPL) and can be found at the ETPL. The ETPL program is used to identify training that may be federally funded under the Workforce Innovation & Opportunity Act (WIOA) meaning that you may be eligible for up to $5,000, even if you do not live in New York State through state reciprocity agreements.

Eligibility is based on several factors that are regionally specific, including if the job being trained for is identified in the local region as one in demand.  It may often be true that cybersecurity is not specifically listed but IT support is and our program is good training for that kind of entry level position as well.

If interested, regardless of where you live, you will need to contact and work with your local employment counselor at your local unemployment office to assess your eligibility and apply for a grant. More information can be found at the link below even if you do not live in Monroe County, New York, and with your local employment counselor.

More Information >

TechRochester:

TechRochester is offering $1,500 scholarships to Rochester area residents who have been displaced as a result of COVID and are pursuing an IT certification to help shift their career.

Apply Here >

Mon, 16 May 2022 02:00:00 -0500 en text/html https://www.rit.edu/cybersecurity/cybersecurity-bootcamp
Killexams : How To Navigate The Top Risk And Security Trends Of 2022, According To Ostendio's CEO

As technology continues to evolve, businesses are seeing both the upsides and pitfalls of advancements like the cloud.

On the one hand, cloud environments have enabled companies to expand their footprints and allow employees to permanently telecommute. In fact, Gartner estimates that around half of all knowledge workers will rarely step foot in a traditional office for the foreseeable future. On the other hand, the virtual aspect of the internet, the cloud, and widespread digitization have opened up organizations to serious corporate security risks.

To get a better understanding of the biggest security concerns facing leaders and brands today, I sat down with Ostendio’s Grant Elliott. As the security and risk management platform’s CEO, co-founder, and chairman, Elliott keeps an eye on the emerging threats that keep business owners and CISOs up at night.

Serenity Gibbons: Let’s start by talking about the most critical risks you’re seeing right now. What’s your top pick?

Grant Elliott: The number one threat faced by businesses is the growing inability to understand where their data is stored and who has access to it. The challenge for organizations today is how to ensure only those required, with legitimate rights, can access and use that data.

Gibbons: That’s scary, given that Beta News reporting estimates about one-third of all hacking incidents can be linked to “inside jobs.”

Elliott: Yes. Failure to identify and manage access to data has led to a rise in both the number of data breaches each year and the related financial and reputational cost to an organization. According to a latest Ponemon/IBM report, the average cost of a data breach is $4.2m, the highest average total cost in the 17-year history of the report.

Gibbons: Okay. What gets your vote for the second biggest type of security threat that needs to be taken seriously?

Elliott: Complacency. When organizations are complacent and take shortcuts to managing risk, security, and compliance, they put their business, employees, and customers at risk.

Gibbons: So an auto-piloted, “set it and forget it” system isn’t feasible?

Elliott: It isn’t. There is no automated shortcut to running an effective security program.

We’ve met with many organizations, who have since become customers, that have either tried to manage the process through spreadsheets or held the belief that an “automated” system could adequately protect their data, only to fail a security audit and put their organization at further risk.

To be successful, businesses must get boardroom buy-in to invest in building robust integrated risk management and data security programs that can be Tested by an external auditor.

Gibbons: I’m guessing that a lot of organizations know about these threats and try to thwart them. Why aren’t they gaining traction?

Elliott: To manage threats, organizations often focus on their production data stored in a cloud environment such as AWS or Azure and fail to recognize that their data might be free-flowing across their organization. Without clear governance and mechanisms to enforce data security, sensitive data can find itself duplicated in all sorts of places providing potential attackers with a multitude of access points.

Gibbons: What’s your best advice for CISOs tasked with trying to make sense of everything?

Elliott: Communicate with your executive team and board of directors. It is important that the modern CISO communicates risk management effectively to ensure corporate buy-in at the highest level of the organization.

Only effective risk management communication will allow the modern-day CISO to ensure they have a sufficient security budget and executive buy-in to drive operational security throughout the extended organization and reduce overall organizational security risk.

Gibbons: Good points. How about a year or two down the road, though? We know that more threats are bound to arise. Are there any pragmatic ways that CISOs can future-proof their corporate systems against today’s and tomorrow’s risks?

Elliott: Businesses should start by managing and tracking all assets at a holistic level. Not just an asset's attributes but criticality, risk, and accessibility. It is also essential to understand integration points because of the increased use of APIs. When a single asset is breached we need to understand if that might deliver back-door access to other assets.

Organizations should also be implementing their security and risk management program in line with an industry-acceptable security standard and ensure compliance by having it audited by a credible and independent third-party auditor to prevent confirmation bias. When sitting for an exam, you don’t get to grade it too.

Gibbons: I’d like to end on a hopeful note. Can you share three positive trends in the risk and security world that you expect to see in the coming five years?

Elliott: Sure. Number one, there are an increasing number of tools available to help organizations protect their data. Organizations will use these tools to help build and operate security and risk management programs on a holistic level. While some automation in these tools may prove helpful, the reality is that people and systems are complex and most controls will continue to be procedural.

The GRC (Governance, Risk, and Compliance) tools of the future will be fully aligned with the core operational tasks of the organization, ensuring that all actions and activities are managed and tracked and that all employee operations work as a matter of process to protect information and provide on-demand evidence for independent verification.

Number two, there will be an increase in demand for security audits and certifications such as SOC 2, FedRAMP, and ISO or to obtain security certifications such as HITRUST. Gartner predicts that 60% of organizations will use cybersecurity risk as a "primary determinant" in conducting third-party transactions and business engagements by 2025. This helps organizations know how to set realistic goals, and build an appropriate and effective security program.

Gibbons: What’s your third expectation?

Elliott: Organizations that have adopted a fully remote workforce will start treating their employees as the first line of defense, rather than as a threat. Employees will become more involved in the security operation and will be measured and rewarded based on this participation. Expectations will be made clearer via more effective process and procedure documentation; more frequent and more targeted training, involvement in security drills such as Business Continuity Plan/Disaster Recovery exercises and clear communication from management around risk management.

We will also see an increased demand for asset management, tracking all data points and who has access, particularly as employees, join, leave or change roles. We call this building a “culture of security” where all employees are involved and trained in how to handle data properly.

Wed, 27 Jul 2022 12:00:00 -0500 Serenity Gibbons en text/html https://www.forbes.com/sites/serenitygibbons/2022/07/28/how-to-navigate-the-top-risk-and-security-trends-of-2022-according-to-ostendios-ceo/
Killexams : Engineering and Management

The engineering and management program consists of 32 credit hours in engineering and management, 31 credit hours in mathematics and science, 18 credit hours in electrical science, and 18 credit hours in other courses. 3 credit hours are in free electives.

All courses are 3 credits unless noted.

Clarkson Common Experience

The following courses are required for all students, irrespective of their program of study. These courses are offered during the fall semester, with FY100 First-Year Seminar being required of only first-year students. Both FY100 and UNIV190 are typically taken during the fall semester of the first year at Clarkson.
FY100 First-Year Seminar (1 credit)
UNIV190 The Clarkson Seminar (3 credits)

Engineering and Management Core Requirements

Students are required to complete the following courses:

Engineering and Management

  • EM120 Team-based Design & Innovation 
  • EM121 Technological Entrepreneurship (2 credits)
  • EM205 Introduction to Financial & Managerial Accounting 
  • EM286 Organizational Behavior I
  • EM313 Professional Communication 
  • EM331 Operations & Supply Chain Management 
  • EM333 Elements of Operations Research 
  • EM380 Project Management 
  • EM451 Quality Management & Lean Enterprise 
  • EM432 Organizational Policy & Strategy
  • EM456 Process Engineering & Design

Professional Experience

Students are required to complete the following Professional Experience:
Internship, co-op, or directed research related to the student's professional goals

 

Math and Science Courses for Engineering and Management

Students must complete the following courses:

Mathematics/Statistics

  • MA131 Calculus I 
  • MA132 Calculus II 
  • MA231 Calculus III 
  • MA232 Elementary Differential Equations
  • STAT383 Probability & Statistics 

Chemistry/Physics

  • CM131 General Chemistry I (4 credits)
  • CM132 General Chemistry II (4 credits)
  • PH131 Physics I (4 credits)
  • PH132 Physics II (4 credits)

 

Engineering Science Courses for Engineering and Management

Students must complete the following courses:

  • ES220 Statics 
  • ES250 Electrical Science 
  • ES330 Fluid Mechanics 
  • ES340 Thermodynamics

Students must choose one of the following courses:

  • ES222 Strength of Materials
  • ES260 Materials Science & Engineering
  • EE264 Digital Design

Business Courses for Engineering and Management

Students must complete the following courses:

  • COMM217 Introduction to Public Speaking 
  • EC350 Economic Principles & Engineering Economics 
  • FN361 Financial Management
  • IS110 Introduction to Business Intelligence and Data Analytics
  • LW270 Law & Society 
  • MK320 Principles of Marketing 

Professional Elective

A professional elective in E&M is a 3-credit course (or equivalent) that predominantly covers engineering or engineering management knowledge. Examples of such courses include any sophomore-, junior- or senior-level course in engineering; any junior- or senior-level course in a topical knowledge area(s) in the Guide to the Engineering Management Body of Knowledge, 3rd edition, ASEM, 2013; or courses focused on information technology.

Knowledge Area/University Course Electives

Students will have at least 15 credit hours available to use toward Knowledge Area and/or University Course electives to satisfy the Clarkson Common Experience requirements.

Free Electives

Students will have approximately 3 credit hours available to use toward courses of their choice.

Thu, 20 Dec 2018 07:13:00 -0600 en text/html https://www.clarkson.edu/undergraduate/engineering-and-management
Killexams : Master of Finance

The Master of Finance (MFin) program at UD offers exceptional preparation for many fields — banking, financial analysis, brokerage, wealth management, private equity, corporate finance, insurance, international business — and many more. The flexibility of our MFin curriculum also makes it possible for students to prepare for a Ph.D. program in Finance. Our innovative curriculum, including a CFA preparatory course, as well as hands-on learning at our two investment centers ensure you will receive an exceptional education with our program. 

The University of Dayton has successfully placed its finance majors in companies such as BlackRock, Bloomberg, Credit Suisse, Fidelity, Fifth Third Bank, IBM, Johnson Controls, JP Morgan Chase, KeyBanc Capital Markets, Mid-America Asset Management, Northern Trust, Wells Fargo Securities, and Fuyao Glass America.

The Master of Finance is a STEM-designated program. Graduates of STEM-designated programs, like our MFin program, are able to apply for a 24-month extension to their normal 1-year OPT, making for a total of 36 months (3 years).

Tue, 27 Apr 2021 11:33:00 -0500 en text/html https://udayton.edu/business/departments/economics_and_finance/master_of_finance/index.php
Killexams : The Unfinished War Atlantic Monthly Sidebar

January 1989
An inside look at how personal enmity, political calculation, and policy misjudgments prevented any effective prosecution of the War on Poverty by either Lyndon Johnson or Richard Nixon. Part two of a two-part article.

by Nicholas Lemann


The American political system is famous for reacting to national crises after they happen instead of anticipating them, but in the case of what became known in the sixties as the urban crisis, the problem was almost the opposite. The Watts riots, in the summer of 1965, made it obvious to everyone that the big-city black ghettos were in bad trouble, and instantly the ghettos became the leading domestic issue. Rather than being caught unprepared, the government already had at least part of the supposed solution in place--the War on Poverty, which President Lyndon Johnson had declared in January of 1964, when there was virtually no political pressure on the government to do anything about either ghettos or poverty. This meant that after Watts, Johnson did not have the luxury of basing a government response to the problems of the ghettos on the lessons of the riots. There were already too many givens. The programs of the Office of Economic Opportunity, the agency created to run the War on Poverty, were well under way, and the OEO quickly defined itself as the locus of riot prevention inside the government. The OEO was fully committed to a poverty-fighting strategy that had emerged while the ghettos were still seen as straitened but strong ethnic enclaves: community action, in which new, independent local organizations in poor neighborhoods would be given federal money to vanquish poverty.

Another problem for the OEO was that an intense rivalry between Johnson and Robert Kennedy was essentially built into it. The War on Poverty was Johnson's first major initiative as President, and Johnson intended it to demonstrate that despite his reputation as a Texas conservative he was more liberal than John F. Kennedy. But the idea of fighting poverty had germinated during the Kennedy Administration, with Robert Kennedy playing a more important role than his brother. In the aftermath of Watts, Johnson was convinced that whatever he did about the ghettos (and Vietnam, where he had committed American combat troops just two weeks before the Watts riots broke out), he would have to contend with the opposition of Robert Kennedy, who was the most popular figure in Johnson's party.

The antipathy between Johnson and Kennedy went back a long way. At the 1960 Democratic Convention, after Johnson had accepted John Kennedy's offer of the vice-presidential nomination, Robert Kennedy humiliated Johnson by coming to his hotel room and asking him to change his mind. Each man made the other a symbol of his greatest disappointment: Kennedy saw in Johnson the end of Camelot; Johnson thought that Kennedy was the main architect of his rejection by the liberal establishment, which made it impossible for him to achieve the Rooseveltian status he wanted.

In the summer of 1965 Harry McPherson, an aide to Johnson, wrote him a memo pleading with him to stop worrying about whether his Cabinet members were more loyal to the Kennedys or to him and to stop opposing good policies just because Kennedy was for them. It contains a fair rendering of Johnson's view of Kennedy:

"He is trying to put himself into a position of leadership among liberal Senators, newspapermen, foundation executives, and the like. Most of these people mistrusted him in the past, believing him (rightly) to be a man of narrow sensibilities and totalitarian instincts....as we know the intellectuals are as easy a lay as can be found. I can imagine them believing that, although Bobby is an absolutist with little sense of the subtle shadings of an argument, and little tolerance for those who cross him, they can still use him to get across radical ideas....The Kennedys are handsome and dashing, they support fashionable artists, and they can pay for almost anything. They support a great many good causes. And to some people even their rudeness and ruthlessness is exciting."

Although the main area of substantive dispute between Johnson and Kennedy was Vietnam, there was also a deep-seated competition between them on race. During John Kennedy's presidency Johnson was the chairman of the President's Committee on Equal Employment Opportunity, and Robert Kennedy was a member. Johnson removed the original executive director of the committee, a Kennedy appointee, and set up a program called Plans for Progress, which tried to get government contractors to hire more blacks voluntarily, nudged along by Johnson-style persuasion. Robert Kennedy, who was worried about how the administration's hiring record would look in the 1964 campaign, favored a tougher system, and considered Johnson's vice chairman, a black man, to be an Uncle Tom. Kennedy and Johnson often quarreled in committee meetings, in a way that went beyond the bounds of usual behavior in government and made the other committee members intensely uncomfortable.

When President Kennedy was about to propose the landmark bill that became the Civil Rights Act, Johnson thought it had no chance of passing, partly because Kennedy was reluctant to undertake a major speaking campaign in its behalf (one Kennedy Administration official has said that the most nervous he ever saw John Kennedy was at a meeting to discuss the Civil Rights Act). Johnson urged the Kennedy people not to propose the bill if Kennedy wasn't prepared to spend his own political capital on it. When Johnson passed the bill, in 1964, there was a feeling in the Kennedy camp that he was taking credit for a Kennedy idea that he had not supported the year before. Robert Kennedy, who even after the assassination referred to his brother as "the President" and to Johnson as "Johnson," sent one of his civil-rights assistants a pen in a frame with a photograph of the ceremony in which Johnson signed the bill (the photograph shows Robert Kennedy in the center of the front row of the audience, staring desolately into the middle distance); the inscription read, "Pen used to sign President Kennedy's civil rights bill."

The personal experiences that Johnson and Robert Kennedy had with race in the sixties were completely different. Kennedy began visiting the ghettos early in his brother's presidency and continued to do so for the rest of his life, but Johnson had relatively little contact with blacks. His favorite story about his own experience with the horrors of segregation had to do with the time his servants, Helen and Gene Williams, transported his dog by car from Washington to Texas and were unable to stay in motels or eat in restaurants. He felt uneasy with civil-rights leaders to the left of Roy Wilkins, of the NAACP, and Whitney Young, of the Urban League- including Martin Luther King, Jr., whom Johnson considered to be vain, preachy, Communist-influenced, and, when King began to oppose the Vietnam War, a man who cared more about posturing than helping his own people. (Robert Kennedy didn't especially like King either.) Up close, Johnson had a hard time treating the many civil-rights landmarks of his administration with the dignity they deserved. He summoned Louis Martin, his closest black political adviser, to the White House for the announcement of the appointment of the first black Cabinet member by saying, "I was sitting in the toilet here and I got to thinking about you." Johnson never completely shed the racial language of his youth: he occasionally used the word "nigger" in private.

Johnson's views on how to solve racial problems were those of a man whose whole world was politics. He began telling friends shortly after the Second World War that he believed that blacks, having fought and died to protect the world from a racist dictator, were not going to, as he put it once in 1948, "take the shit we're dishing out" much longer. The best peaceable route to equality for blacks, he thought, was "vote power." When he heard about the Supreme Court's decision in the 1954 Brown v. Board of Education case, he told a friend, "They should have done voting rights first and then education." He believed that politicians are largely prisoners of their constituencies and that black enfranchisement would quickly change the supposedly intransigent southerners in Congress. "If they deliver the blacks the vote, ol' Strom Thurmond will be kissing every black ass in South Carolina," he told a friend once. He knew this lesson from his own life. He never liked segregation, but for a long time he confined his passionate public outbursts against it to settings where he knew his career wasn't at stake.

Just as it was instinctive for Johnson to think of racial problems in political terms, it was instinctive for Kennedy to believe that a deep-dyed politician like Johnson was incapable of truly confronting racial problems. Much more than most people in government, Kennedy saw life as a morality play, and he came increasingly to reject the New Deal and the flabby, talky, deal-making politicians who were its legatees in the Democratic Party "God, I hate that," he told his aide Peter Edelman after a long meeting with the California politician Jesse Unruh in 1968. "We used to send Larry O'Brien to do that....He could talk the balls off a brass monkey." A few weeks after the assassination Kennedy told Arthur Schlesinger, Jr., "My brother barely had a chance to get started--and there is so much now to be done--for the Negroes and the unemployed and the school kids and everyone else who is not getting a decent break in our society....The new fellow doesn't get this. He knows all about politics and nothing about human beings."

In the spring of 1966, during the formulation of Johnson's Model Cities program, which was designed to spend billions on the rehabilitation of the ghettos, Kennedy arrived late at a small dinner attended by several administration officials and delivered a tirade against Model Cities. "He said, 'It's too little, it's nothing, we have to do twenty times as much,'" says one person who was there. Kennedy began to distance himself more and more publicly from the Johnson Administration. He served as the conduit for a "peace feeler" from the North Vietnamese, participated in hearings on hunger in Mississippi, helped orchestrate hearings on the urban crisis which were critical of the Johnson Administration, and proposed bills to create two million new public-service jobs and so channel government and private investment into rebuilding the housing stock and employment base in the ghettos. Johnson, a devoted believer in the Getting Things Done faith, had no respect for this kind of position-striking; he considered the real purpose of all Kennedy's actions to be the embarrassment of Lyndon Johnson. He opposed Kennedy's jobs bill, his ghetto-development bill, and an expansion of the food-stamps program which was proposed after the hunger hearings.

It is commonly said that Vietnam drew Johnson's attention away from the War on Poverty and weakened his financial commitment to it. That may be, but if the war in Vietnam had suddenly ended, Johnson would still have disliked the War on Poverty for having turned out to be, to his mind, a stronghold of his enemies.

His general attitude is indicated by a memo that Harry McPherson, mimicking Johnson, wrote to Joseph Califano, Johnson's chief domestic-policy adviser, as a comment on a letter from a small-town Ohio Jaycee complaining about the OEO: "If you and Sarge [Sargent Shriver, the head of the OEO] weren't in this thing and always working and humping for that program that never mentions anybody's name we wouldn't get into this kind of problem with these people here. Neither one of you ever ran for constable and you just can't sit still for wanting to talk about this program everybody says is just criminal and wrong."

Johnson told Wilbur Cohen, a high official at the Department of Health, Education, and Welfare, that he considered virtually everyone at the OEO to be disloyal and a troublemaker. "They're not against poverty, they're for Kennedy," he told his adviser Bill Moyers. Toward the end of his term Johnson had a rueful conversation with Abe Fortas, then a Supreme Court justice, in which he recalled that an old New Deal friend of his and Fortas's, Elizabeth Wickenden, had been unable to gain the ear of anyone in the administration for her warnings about community action in late 1963 and early 1964. "I should have listened to Wicky," Johnson said.

In the final stages of his presidency the idea of large-scale government programs for the ghettos had become so bound up in his mind with liberal opposition to him that Johnson became positively hostile toward them. He was deeply suspicious of the Kerner Commission, which he had appointed after the terrible Newark and Detroit riots of 1967 to determine how future riots could be avoided. Johnson was convinced that there was a conspiracy behind the riots--in fact, Shriver had to reassure him that OEO employees were not instigating some of the riots. David Ginsburg, the Kerner Commission's executive director and an old friend of Johnson's, says that when Johnson called him in after his appointment, "he made it very clear that in his view it was simply not possible to have so many outbreaks at the same time without someone orchestrating it.

The Kerner Commission recommended billions of dollars' worth of new government programs for the ghettos, which Johnson thought put him in an impossible position, by making whatever he did thereafter look like a sellout. Despite the entreaties of his staff, he refused to comment on the report, refused to allow the commission to present it to him, refused even to sign the form letters his staff drew up thanking the members for their work. "I just can't sign this group of letters," he told Harry McPherson. "I'd be a hypocrite. And I don't even want it let known that they got this far...otherwise somebody will leak that I wouldn't sign them. Just file them--or get rid of them."

On April 10, 1968, in the aftermath of Martin Luther King's assassination, Joseph Califano sent Johnson a long memo suggesting that he react to the crisis by making an address to a joint session of Congress, adding billions to anti-poverty programs, and appointing well-known experts to look into a major re-ordering of the government's fiscal priorities. Johnson, who rarely wrote anything down, scrawled angry comments all over the memo. To Califano's reminder that he had promised to address a joint session of Congress, Johnson responded, "I promised nothing. I stated my intention only. Since changed by riots." To the suggestion that he ask the advice of "someone with a completely open mind," like McGeorge Bundy, the former national security adviser who was then the very visibly liberal head of the Ford Foundation, Johnson responded, "Ha! Ha!" At the end of the memo he wrote, "Forget it."

HOW THE GHETTOS COULD BE HELPED

In the founding days of the war on poverty, Sargent Shriver and his aides assumed that as time went on, their efforts would only become grander. There would be much bigger budgets. As new ideas about fighting poverty emerged, they could be tried out, and expanded if they worked. Instead, Shriver's group found that as the importance of the problem they were working on became clearer, their room to maneuver steadily decreased. Instead of spending the late sixties experimenting with new programs, they were forced to defend the programs already in place--in particular, community action.

In 1964, when the enabling legislation for it was passed, community action was not a widely agreed-upon cure for poverty. It stood in relation to mainstream liberalism as supply-side economics would to conservatism in 1981: it was an untested idea championed by a small group of thinkers who seized an opportunity to make it government policy. Just as supply-side tax cuts have never been clearly shown to do what they're supposed to--increase government revenues--community action never demonstrably reduced poverty in a neighborhood. Still, by the end of the sixties, if community action itself had not become a part of the political consensus about ghettos, its lineal descendant community development had. Community action was designed to let poor people substantially determine their own poverty-fighting strategies, which might be anything, including organizing opposition to the local power structure. Community development meant, more simply, turning the ghettos into healthy neighborhoods: rebuilding the housing stock, establishing an economic base by encouraging the location of factories and offices and the creation of new businesses there, and strengthening the web of local church, voluntary, and political organizations. This was a much more concrete and politically acceptable idea than community action, but there was still no proof that it would work. One of the reasons no other coherent political solution to the problems of the ghettos emerged in the late sixties is that in every other case the way was blocked.

Besides community action and community development, three other broad paradigms for helping the ghettos were part of the public discourse in the late sixties. One was racially desegregating the northern cities; another was simply giving poor people money; another was giving them jobs.

The idea of integration as a cure for the ghettos, with its implication that blacks would do well to assimilate into white culture, lost some of its appeal for liberals because of the rise of the black-power movement. But by far the most politically important opposition to integration came from whites who weren't liberal, especially whites in the North. Every elected official in a northern city knew that the residential line between black and white neighborhoods was the place of maximum political danger to him. Robert Kennedy said in 1964 that his brother had been late to issue a housing desegregation order that he had promised during his presidential campaign because northern Democratic congressmen were worried that it would hurt them in the 1962 elections. Over the Christmas holidays in 1962 John Kennedy had mentioned to an aide that it would be a good idea to break up the black ghettos, but very difficult politically.

In 1965, after the Johnson law that established federal aid for local school districts as a major government program went into effect, the commissioner of education threatened to withhold funds from the Chicago school system, largely on the grounds that it was segregated. Mayor Haley spoke with the President, and the commissioner of education was moved to a different job. In 1967 the next commissioner of education was stripped of his civil-rights-enforcement responsibilities after offending powerful congressmen on the integration issue. The Model Cities bill, proposed by Johnson in 1966, originally contained a provision requiring that local Model Cities projects promote residential integration; Senator John Sparkman, of Alabama, the chairman of the housing subcommittee, objected, and all mention of integration was dropped from the bill.

We are now in a period of widespread concern that welfare, if not carefully limited, will reduce its recipients to a state of permanent dependency. But from roughly 1961 to 1975 liberal opinion overwhelmingly supported the idea of a "guaranteed, annual income"--that is, giving all, poor people enough money to lift them out of poverty. Shriver, who at the outset of the War on Poverty was promoting slogans like "A hand up, not a handout," had within a year become a convert to the idea of a guaranteed income, and he proposed it to Johnson.

The problem was that Johnson hated welfare. "You tell Shriver no doles," he said to Bill Moyers early in 1964. On Johnson's instructions the economist Lester Thurow, then on the staff of the Council of Economic Advisers, was given the task of going through the annual Economic Report of the President and removing anything that could be construed as a reference to putting cash in the hands of poor people. One year the White House staff succeeded in slipping into the annual presidential budget message a promise to extend welfare benefits to families with unemployed fathers, which was supposed to be the way to make sure that welfare wouldn't break up families; Johnson refused to follow through, because he saw it as more welfare. (This change will finally take place in October, 1990, as one of the provisions of the major welfare-reform law that Congress passed last fall.) In 1968 he appointed a presidential commission on income maintenance, but nothing ultimately came of its work. All through the Johnson Administration a welfare solution to poverty (except poverty among elderly people on Social Security) was not a serious option, because of Johnson himself. And in this one instance Robert Kennedy was never willing to embrace the liberal anti-Johnson position, because he, too, was against welfare, and resisted the entreaties of his staff and of Martin Luther King, among others, to endorse a guaranteed income.

There was no similar opposition at the top to the idea of creating jobs. Johnson had established a large publics works jobs program from scratch when he was the Texas director of the National Youth Administration, in the thirties, and his glowing memories of its success made him instinctively like the idea of jobs programs. Robert Kennedy, through the late sixties, was a strong advocate of a federal jobs program for the ghettos. Shriver's favorite anti-poverty program was the Job Corps, so named partly because his aides decided that job was the only word in the entire lexicography of government programs with no negative connotations. The government's failure to adopt a large-scale jobs program in the sixties seems especially painful today, because, unlike a guaranteed income, jobs programs are still widely proposed as the answer to the problems of the ghettos.

One reason--probably the main reason--that a big jobs program never happened in the late sixties is the cost. Creating jobs is the most expensive kind of anti-poverty program, much more expensive per beneficiary than even a generous guaranteed income. In the early planning stages of the War on Poverty, when there was a ceiling of $500 million on its entire budget, Willard Wirtz, the Labor Secretary, was proposing $3 billion to $4 billion a year just in Labor Department jobs programs. In February of 1964 Wirtz, with Shriver's blessing, made a plea at a Cabinet meeting for a new tax on cigarettes to finance his jobs program, and Johnson snubbed him, first turning his head in a sideways pout so as not to look at Wirtz, and then picking up his ever-present telephone and making a few calls in the middle of Wirtz's presentation. The people there took this to be Johnson's way of saying that he didn't want to raise taxes just then.

Economists, who were very important in the planning of the War on Poverty (the original idea of an anti-poverty program had come from the White House Council of Economic Advisers), tended to be unenthusiastic about jobs programs, because they thought that bringing down the overall unemployment rate through fiscal and monetary policy would do more good. Organized labor, at the time the most powerful Democratic interest group by far, was always touchy about jobs programs, because they might weaken wages and compete with unions. (The Job Corps didn't ruffle labor's feathers, because it was engaged in job training in special camps far away from the labor market, and it didn't create jobs. Most of the success stories about it involve graduates of the camps who joined the military, rather than getting skilled jobs in their home towns.) Also, the two leading advocates of creating jobs, Wirtz and his assistant secretary for policy planning, Daniel Patrick Moynihan, were not skillful bureaucratic players. Their ideas were good, but Wirtz and Moynihan were not good at selling them.

In the earliest days of the War on Poverty, Wirtz adopted a position that Shriver's group (to whom he had to sell his poverty-fighting ideas, because they were the ones writing the legislation) found extremely annoying: proposing unrealistically expensive programs and insisting that they be run by the Labor Department instead of the OEO. While HEW, the OEO's other established rival, cooperated with the poverty warriors, Wirtz refused to be a team player, and he took every tiny detail so seriously that dealing with him on anything came to be viewed as an onerous chore.

Moynihan, for his part, was not much more beloved by Shriver's group than Wirtz was. He was given the task of drafting the presidential message that would accompany the Economic Opportunity Act, the initial piece of War on Poverty legislation; his draft came in late, was too long, and emphasized jobs to the near exclusion of community action, which was meant to be the centerpiece of the legislation. Shriver's task force scrapped it. Moynihan now remembers going to see Kermit Gordon, the budget director, to warn him about the political perils of the community-action program, which sent its funds into neighborhoods without necessarily going through the local mayor and congressman. He recalls, "I said, 'I know you've thought of community action as a way of coordinating services at the local level, but another view is, they could raise a lot of hell.' But I realized there was no point in going on, because it was clear that Kermit Gordon thought I was out of my mind."

When Wirtz heard about the Job Corps, he wanted the Labor Department to run it. Since the Job Corps was so important to Shriver, the last thing he would have done is let Wirtz control it. To mollify Wirtz, Labor was given jurisdiction over the second-biggest employment program in the War on Poverty, the Neighborhood Youth Corps. But Wirtz remained bitter, and blamed Moynihan, his emissary to Shriver, for having let the Job Corps slip away. When Moynihan took time off to work in Robert Kennedy's Senate campaign in New York, Wirtz let Johnson know about it, which guaranteed Moynihan a permanent place in the President's bad graces.

Wirtz and Moynihan continued to be the most ardent advocates of jobs programs within the administration, and anything they proposed drew almost automatic opposition from the White House. Wirtz's hammering finally induced Johnson to ask Kermit Gordon to price out a jobs program; Gordon's memo, written in early 1965, stands out today in the reams of White House memos on the ghettos as the one that most gives rise to the thought, Now this really would have helped. It recommended creating 600,000 new unskilled public-works jobs, expanding delivery of the mail (the Postal Service was then the major employer of blacks in the government), and increasing the OEO payroll by 100,000 on the theory that it could fight poverty better as an employer than through ministrations to the poor. But the memo is full of subtle bureaucratic cues that said to Johnson, Don't do this--it would be expensive and politically unpopular. Johnson didn't do it.

The Labor Department was always looking for ways to dramatize the need for jobs programs, even during a time of a falling national unemployment rate. Moynihan, a great spotter of trends, had seen an item in The Washington Post in 1963 saying that the Selective Service was rejecting half of all potential draftees, because they couldn't pass the military entrance exams. He got the idea of conducting a national survey of the Selective Service rejectees, which would provide Wirtz with dramatic evidence that poor young men, and especially poor black young men, needed special training--by the Labor Department, of course. The study (named "One-Third of a Nation," to evoke FDR) did not produce action from Shriver's group, though; Labor needed more ammunition.

THE INFAMOUS REPORT

Toward the end of 1964 Moynihan noticed another significant little fact: although the black male unemployment rate was going down, the number of new welfare cases was going up. Also, the percentage of black babies born our of wedlock was rising. Moynihan, a man with a journalistic love of the scoop, was eager to get this information out quickly. He decided to begin work on a new report, "The Negro Family: The Case for National Action." From the Christmas holidays of 1964 to February of 1965 his staff worked on the report full time, meeting with Moynihan to discuss their progress at the end of every day and not even taking weekends off. Drawing on the work of the sociologist E. Franklin Frazier and the historians Stanley Elkins and Frank Tannenbaum, they assumed that American slavery had been so brutal that it had weakened the traditional husband-wife family structure among blacks, and that the welfare system and high unemployment in the ghettos had hurt the black family still more. Now the ghettos were, as the sociologist Kenneth Clark put it in Dark Ghetto, characterized by "pathology."

Wirtz wanted Moynihan to end the report with policy recommendations, but Moynihan didn't. He said that he didn't want to deliver people who disagreed with the recommendations an excuse to ignore the problems; also, he was never as zealous as Wirtz in promoting the bureaucratic interests of the Labor Department. The report began to circulate inside the government. Johnson's Howard University commencement speech, written by Richard Goodwin and delivered that June, contained a passage about the black family that drew on the Moynihan report. At Howard, Johnson announced that a big White House conference would be held in the fall of 1965 to discuss the next step in civil rights, and plans were made for a panel on the black family.

Although the report was supposed to be secret, copies began to leak out. A story in The New York Times in July of 1965, for example, described the report in great detail. Although Moynihan always insisted that he had written the report for a small, private audience of policy-makers, his colleagues suspected that he had caused a copy or two to pass into the hands of people outside government. Moynihan at heart was more a writer than a bureaucrat. Even now, he not only writes books but also (a still surer sign of a real literary temperament) can remember specific lines from bad reviews twenty years after they appeared. His achievements in government have been more intellectual than political. The classic Moynihan pattern, broken only when his welfare-reform bill passed last year, with much help from other senators, is to propose a wonderful and original initiative and then see it fail to be enacted. As an example of a type, he is more English than American, the gentleman scholar-politician whose writing is passionate and graceful but does not relish the spade work that both pure academics and pure government officials in this country usually have to do.

The word "attention" has come up repeatedly over the years in Moynihan's explanations of why he wrote the black-family report--attention to the problem, of course, but Moynihan has never minded personal attention either. He had the classic writer's fear of being denied the credit for an original thought. In the summer of 1965 he had a special reason for wanting a higher profile--he was preparing to run for president of the New York city council in the fall.

The report did not get attention from the one person in the best position to do something about the problem: Lyndon Johnson. He didn't read it. But it got a fantastic amount of attention in Moynihan's own intellectual world, almost all of it negative and much of it bitterly, wildly, unreasoningly hostile. The Moynihan report might be the single most refuted document in American history, a slim pamphlet to whose discrediting book after book has been devoted. There was a mood change among liberals, after the Watts riots, that coincided almost exactly with the publication of the Moynihan report and caught Moynihan by surprise. For a professor he was not averse to a little rough-and-tumble. He had grown up partly in the slums himself, and was raised by a single mother. He knew what the world was like. His best-known work at the time, the chapter on the Irish in Beyond the Melting Pot, was written with an air of jaunty confidence that the time had come to talk about ethnic-group characteristics (like his own group's drinking) in a frank way, and let the devil take the hindmost. Now he had come up against the black power movement, which did not like it when a white man described black society as being somehow ruined, and also against the white left, which was becoming less sympathetic to the idea that the values of middle-class America--the values that had gotten us into Vietnam--were so noble that poor people ought to embrace them.

The White House conference was postponed until the next year. Moynihan lost his race in New York. He withdrew to academia, and his mood became understandably bleak. In 1966 he wrote Harry McPherson, his closest friend on the White House staff, that his current status as a pariah was so obvious that "if my head were sticking on a pike at the South West Gate to the White House grounds the impression would hardly be greater." He became convinced that the left had become the greatest obstacle to the achievement of liberal goals. His report was after all a call for "national action" in the area of employment, and the reaction to it, inaccurately painting it as an attack on poor blacks and thus neutralizing it, was the prime example.

In government the effect of the Moynihan report was to make black out-of-wedlock childbirth--and, more broadly, the "culture of poverty" in the ghettos, which had been a staple of liberal books of the early sixties (notably, Michael Harrington's The Other America)--a taboo subject. Johnson's attitude toward the report was, in Bill Moyers's words, "I don't know what was in there, but whatever it was, stay away from it." Moynihan wrote to McPherson, "Obviously one can no longer address oneself to the subject of the Negro family as such." He dropped his own plans to write a book on the subject. Not until 1975, when Eleanor Holmes Norton gave a keynote address at the Urban League on the black family, did a prominent black leader publicly address the issue. The whole idea that there was any kind of inherent weakness in black ghettos became disreputable, and the prohibition of discussions of the ghetto culture seemed to strengthen the idea that the ghettos could be turned around.

TRYING TO HEAL THE GHETTOS FROM WITHIN

The rejection of any other overall strategy for helping the ghettos had the effect of strengthening liberals' allegiance to the community-action program. Community action was unpopular in Congress, but defending it became a cause, partly because there was nothing else around to defend. Over time the claim made for community action became attenuated: the program was not so much reducing poverty as it was developing a new generation of black leaders. Indeed, many people have since gone from jobs with community-action agencies to elective office, although if there had never been a community-action program, demographics and the Voting Rights Act would still have practically guaranteed a great increase in the number of black elected officials.

As the community-action creed gained adherents, there was a constant struggle, inside the OEO and in the liberal press, to push local community-action agencies to serve the "hard-core poor" rather than the "easy-to-reach poor"; to steer the funding straight to community groups, bypassing elected officials; and to support strategies of political confrontation instead of accommodation. It was in a way inevitable, given the roots of community action in the theory that juvenile delinquents turn to crime only because of a lack of legitimate opportunity, that the OEO would come to the idea of funding youth gangs. The OEO did so in Chicago.

The Woodlawn Organization, in Chicago, founded by Saul Alinsky in a black neighborhood on the South Side, was by the mid-sixties a national model for liberals of how a community organization could turn a ghetto around (though by then the Woodlawn neighborhood was already suffering heavy population losses). Two gangs, the Blackstone Rangers and the East Side Disciples, were engaged in violent warfare over the turf of Woodlawn. Inside the community-action world, the feeling was that the gangs were really part of the legitimate leadership structure of the community and could be made into a positive force if provided with opportunity in the form of a federal grant. In 1967 the research and demonstration division of community action, which was more daring than the operations division, gave The Woodlawn Organization $927,000 to run a job-training program that would use the gang structures of the Rangers and the Disciples to teach teenagers the skills they needed to enter the labor force. The grant "will put the Blackstone Rangers and the East Side Disciples to work," Shriver wrote Joseph Califano exultantly. "The City Police will see that armed fighting stops between the Rangers and the Disciples, and that our money is not used 'to arm both sides'....Finally, the grant was concluded without any exhortation from the Citizens Crusade Against Poverty, Walter Reuther, RFK, Chuck Percy, Dick Boone, the Presbyterian ministers, Pat Moynihan, or other heavy thinkers."

The grant was made in June. By December two of the gang members receiving funds had been arrested on murder charges. (The Blackstone Rangers went on to change their name to the El Rukns and to run into legal trouble for such activities as dealing cocaine and contracting with the Libyan government to carry out terrorist activities in the United States.) The Chicago press and the conservatives in Congress, having been handed an example of criminal-coddling by Washington liberals more perfect than they could have dared dream of, launched a flotilla of exposes, denunciations, and hearings. Johnson was furious, and the grant was canceled in 1968--but it is a testament to the power of the idea of community action that many of the people who were leaders of the OEO at the time are still proud of it.

Community action introduced into the discourse the idea that urban black poverty could be solved from within the ghettos. This idea became much more appealing politically when decoupled from the OEO's tendency to engage in confrontation with the power structure. The beauty of community development for a politician was that it allowed him to express concern about the ghettos without angering white neighborhoods. Community development did not imply busing, opposition to which by the mid-sixties was already strong in many neighborhoods. It did not imply scatter-site public housing. It did not imply shifts in the compositions of congressional and councilmanic districts (every established local politician likes a stable constituency). It was popular among blacks in the cities, because it connoted pride and community control and jobs. It had a strong crossover appeal to Republicans, even those from districts where integration wasn't an issue, because it put government power in local rather than federal hands and promoted small business development.

Although Johnson sponsored a large community-development program in Model Cities, the most important patron of community development in Washington was Robert Kennedy. Perhaps part of its appeal to him was that the Kennedy family's success was rooted in an ethnic urban ghetto. Community development would also have appealed to the side of Kennedy that was uncomfortable with the New Deal approach to government. The liberal positions that he took as a senator from New York were in a way misleading; he never really considered himself a liberal. He said in 1964 that his father's famous remark about all businessmen being sons of bitches applied to liberals, too. Right up to the end his pantheon of heroes included General Douglas MacArthur, Herbert Hoover, General Maxwell Taylor, and C. Douglas Dillon--tough, unsentimental men who did things. Community development seemed lean and practical. The entities Kennedy proposed to promote it were always called "corporations." Politically, advocating community development was an element of Kennedy's famous ability to appeal both to blacks and to white ethnics. In a debate with Eugene McCarthy before the 1968 California primary, he accused the integrationist McCarthy of wanting "to take ten thousand black people and move them into Orange County."

All during the ascendancy of the idea of community development the ghettos were going through a kind of community devolution, suffering heavy losses of population, housing stock, and institutional life. Model Cities, like community action, on the whole failed to turn the ghettos around, and like community action, it is praised today mostly for its success in leadership development. Robert Kennedy's large community-development program in Bedford-Stuyvesant, a black neighborhood in Brooklyn, is one of the few efforts that seem to have had any lasting effect. The neighborhood has stabilized, thanks in part to a tremendous influx of outside resources, but even in Bedford-Stuyvesant, Kennedy's dream of creating jobs inside the ghetto was hardly realized. Only one major employer, IBM, was induced to open a plant in Bedford-Stuyvesant, and IBM was unusual among corporations for having a Democratic board chairman and two senior executives who were former Kennedy aides.

Black poverty decreased substantially during the sixties, even as the ghettos were deteriorating: 55 percent of blacks were poor in 1959, and 32 percent in 1969. The strong economy helped accomplish this, and so did the many and varied domestic works of Lyndon Johnson other than the War on Poverty: the Civil Rights Act and education programs and affirmative action, among others. The Great Society's less obvious role as an employer of blacks was also crucial. The political scientists Michael K. Brown and Steven P. Erie estimated in 1981 that the Great Society created two million new government jobs, most of them nominally in state and local government but funded by new federal programs in education, health housing and other social-welfare areas. A disproportionate share of these jobs went to blacks- Brown and Erie estimated that black employment in public social-welfare programs increased by 850,000 from 1960 to 1976, a period during which the black middle class tripled in size. In 1970 the government employed 57 percent of black male college graduates and 72 percent of black female college graduates.

The government social-welfare programs of the sixties--compensatory education Medicare and Medicaid, child nutrition, and so on, as well as the programs of the War on Poverty--gave jobs to hundreds of thousands of blacks (many of them the "easy-to-reach" poor the OEO was trying to avoid: that is, people with an education) who used their newfound modest prosperity to leave the ghettos. In effect, all the while that employment programs were losing out to community-development programs within the high councils of the government, employment was working as a solution to ghetto poverty and community development was not.

THE MOST FREE-SPENDING ADMINISTRATION

Richard Nixon attained the presidency having won probably the smallest percentage of black votes of any President in American history, as his new adviser on urban affairs, Daniel Patrick Moynihan, reminded him in March of 1969. Very occasionally Nixon entertained wistful hopes about discovering a contingent of blacks who would vote for him--"30% who are potentially on our side," he once scribbled in the margin of a memo--but on the whole he was far too much the realist to believe that he would ever have a black constituency. Race was hardly the uppermost of his concerns. In the fifties he had a mildly liberal reputation on civil rights. As Vice President he was an honorary member of the NAACP, served as chairman of the President's Committee on Government Contracts, which was intended to make sure that blacks got a share of the government's business, and got to know black leaders, including Martin Luther King, Jr. But when he ran for President in 1960, he backed away from civil rights (for example, when his running mate, Henry Cabot Lodge, said that Nixon would appoint a black Cabinet member, Nixon instantly denied it), and in the 1968 presidential election he wooed and won millions of traditionally Democratic white voters who were unhappy with Lyndon Johnson's ardor on racial issues. The biggest states that Nixon lost in 1960 and won in 1968 were all ones in which white backlash was a significant force: Illinois, New Jersey, Missouri, North Carolina. "There were subliminal racial messages in a lot of Nixon's campaigning," says John Ehrlichman, who was Nixon's chief domestic policy adviser. "It was subtler than code words. It was, 'I am on your side. I am going to deal with it in a way you'll approve of.' I know he saw Johnson's embrace of blacks as an opportunity. He exploited it."

Ehrlichman says that on two occasions Nixon told him that he considered blacks to be less intelligent than whites. "He thought, basically, blacks were genetically inferior," Ehrlichman says. "In his heart he was very skeptical about their ability to excel except in rare cases. He didn't feel this way about other groups. He'd say on civil-rights things, 'Well, we'll do this, but it isn't going to do any good. He did use the words 'genetically inferior.' He thought they couldn't achieve on a level with whites."

Given Nixon's feelings about race, and given that anything he did on civil rights was unlikely to get him votes in 1972, what is surprising about his first term in office is how much social-policy making meant to help blacks went on. HEW pushed forward with many school-desegregation cases in the South. Labor established the use of numerical goals in affirmative-action plans. Nixon signed into law (granted, he was under congressional pressure to do so) a program to create temporary jobs in the ghettos, a subsidized housing program, revenue sharing and block grants for cities, increases in welfare payments, a major expansion of the food stamps program, and a new program under Social Security that made payments to disabled people, among others; and he proposed a guaranteed annual income. That unpleasant period in the past that Republicans like to talk about, when we threw money at our problems, was really the first Nixon Administration more than it was either of the Democratic administrations of the sixties.

Presidencies are shaped by their times, far more than they shape their times. Nixon's first term took place in the ideological shadow of the sixties. The consensus, such as it was, in Congress, in federal agencies, and among judges and intellectuals was more liberal than it had ever been before and than it has been since. Among the people advising Nixon on domestic affairs, those we would now think of as conservative Republicans were distinctly in the minority. For most of the rest, the sense was that, as one former Nixon adviser, Richard Nathan, puts it, "we just didn't have a new conventional wisdom--we accepted the paradigm of the Great Society." There was a feeling in the Nixon White House, not least on the part of Nixon himself, that racial issues would call forth a particularly Republican strain of virtuousness that the nation had been deprived of during the sixties. The Democrats were the messy, passionate, ultra-political party and the exemplary Democrat was Lyndon Johnson, who always overheated the rhetoric, who cloaked calculation in talk of the public good, who raised expectations too high and worked the country into a frenzied state bordering on real instability. On January 20, 1969, Johnson's aides turned over to Nixon's a stack of blank executive orders declaring martial law--all you had to do was fill in the date and the name of the city. The Nixon Administration would cool off the country (It was a point of pride that major summer riots, which had occurred every year under Johnson, disappeared as a national problem after Nixon took office. There are many theories as to why, not all of them crediting Nixon.) On race, the administration would carry out the law even though there was not a single vote to be gained by doing so. Somehow this seemed purer than the racial concern of politicians like Johnson and Robert Kennedy, who expected the reward of black votes.

"Disgraceful in past 100 years both parties have demagogued the race issue," read Ehrlichman's notes of what Nixon said to a group of his aides in a meeting in 1971. "Used the issue. Haven't tried to solve it." Nixon constantly emphasized to the people around him the importance of keeping a low profile while carrying out civil rights policy. "Don't let the federal government be heroic," the notes continue. "Won't help blacks or the cause." In 1970 H. R. Haldeman, Nixon's chief of staff, wrote a memo summarizing Nixon's views on desegregation. It began, "All people concerned are to do only what the law requires and they are to do it quietly without bragging about it." The memo continued, "We have to do what's right, but we must separate that from politics and not be under the illusion that this is helping us politically."

Nixon knew that by far the most perilous domestic issue for him was the integration of schools and neighborhoods in northern cities. He frequently reminded his aides that he was strongly opposed to busing in the North. Members of his administration who were seen as grandstanding for integration, such as Leon Panetta, the director of the Department of Health, Education, and Welfare's Office of Civil Rights, and James Allen, the commissioner of education, usually found themselves out of a job. In 1970 Ehrlichman wrote Nixon about another problem official, George Romney, the Secretary of Housing and Urban Development: "Suburban Integration. This is a serious Romney problem which we will apparently have as long as he is there. There is no approved program as such, nor has the White House approved such a policy. But he keeps loudly talking about it in spite of our efforts to shut him up....And he is beginning some administrative maneuvers in that direction." Nixon wrote back, "Stop this one." After his re-election, in 1972, when he was reshuffling his Cabinet, he told James Lynn, Romney's successor at HUD, according to Ehrlichman's notes, "Black problem. Romney pandered."

Occasionally Nixon wondered whether he was being unfair to the South by desegregating the schools there and not in the North. Patrick Buchanan, who was one of his speechwriters wrote him a memo on this theme in January of 1970. Buchanan's position was that desegregation should not occur in the South or the North. Nixon wrote in the margin, "Is de facto segregation OK in the North and not in the South?" and "Why should we continue to kick the South and hypocritically ignore the same problem in the North?" By March, though, when Buchanan was fighting with the rest of the White House staff over what position a presidential message on desegregation should take, Nixon had grown comfortable with continuing quietly to undo legal segregation in the South without taking on segregation in the North. "No good politics in PB's extreme view: segregation forever," Ehrlichman noted about what Nixon told him in March of 1970. "Right: Believe should carry out desegregation. Integration not wave of future. No massive program. Lean [toward the position that] integration hasn't worked."

MOYNIHAN FIGHTS TO SHOW WHO'S REALLY LIBERAL

Nixon did not share Lyndon Johnson's desire to be perceived as a great liberal President on domestic matters, but he did have in common with Johnson an inability to be indifferent to the scorn of liberals. From the memo traffic of his White House it is obvious that the left-liberal political culture that had sprung up since the mid-sixties and that reached its zenith during his administration was much on his mind. It was easy for him to conjure up a nightmarish picture of the legions of Nixon-haters: Ivy League professors, black-power advocates social-change promoting foundation executives, peace-marching Georgetown hostesses, affluent student revolutionaries, and to-the-barricades journalists. While studying about Leonard Bernstein's fundraising party for the Black Panthers in 1971, he wrote a note to himself: "The complete decadence of the American upper class intellectual elite." There was a close connection between these people and racial issues: in domestic politics, race was the main issue they should use in order to heap abuse on Nixon.

Several people in the White House shared Nixon's feelings about the left-liberals, but for intensity and eloquence nobody came close to Moynihan, who as a result of his battles with the OEO and the abuse he got for his report on the black family had come to the conclusion that the intellectual left was, as he wrote in 1967, "as rigid and destructive as any force in American life." Joining a Republican administration was for him partly a matter of simple ambition, but it was also a sign of his mood after four years of severe battering.

Moynihan's view of the state of the nation during 1969 and 1970, when he was working in the White House, was a dire one, It was a dire time--the time of Kent State and Cambodia and My Lai--and it seemed particularly so from the vantage point of the academic-literary subculture that Moynihan lived in. He saw the basic social peace of the country as endangered by the left. In May of 1970 he reported to Nixon that the Students for a Democratic Society had threatened to burn down his house in Cambridge and that his family had gone into hiding ("Even so, I'm sticking here. I am choosing the interests of the administration over the interests of my children"). Later that year he told Nixon that his ten-year-old son was afraid that his father would be assassinated.

Moynihan wrote Nixon just before his inauguration, "Your task, then, is clear: to restore the authority of American institutions. Not, certainly, under that name, but with a clear sense that what is at issue is the continued acceptance by the great mass of the people of the legitimacy and efficacy of the present arrangements of American society." As he put it more directly the following year, "To be blunt, the people who brought down Johnson want to bring down Nixon."

Nixon valued Moynihan, especially early in his administration, not just because of the hurts and resentments they shared but also because Moynihan appealed to his intellectual side. "He's so stimulating," Nixon told Ehrlichman once. Moynihan could discern and articulate a grand overarching purpose in the administration's many activities, and could explain to Nixon the similarities between his situation and that of other distinguished statesmen he knew Nixon admired: Lincoln, Roosevelt, Wilson, Churchill. Whom else was there for Nixon to talk with about his admiration for Disraeli, or for War and Peace? Also, Moynihan was useful for the quality of his radar: in 1969 he told Nixon that feminism was going to become a major social force, and in 1970 he predicted that there would be a series of urban fiscal crises. (Like Babe Ruth, he had a lot of strikeouts as well as home runs: he also predicted that the student movement would have lasting political importance and that "mutiny in the armed forces" was a real possibility.) He was full of ideas for grand initiatives: a constitutional convention in 1976, a Nixon architectural policy, a new federal Department of Higher Education and Research. He had a grand strategy, too, and it reflected his perspective, which was that of a bit of a provincial in the intellectual world: Nixon's domestic program would be aimed partly at solving social problems but even more at defusing the left.

Nixon thought that bringing intellectuals around to supporting the administration would be part of Moynihan's job, but Moynihan realized in 1969 and 1970 that this was impossible. What he and Nixon could do, though, was build a record of liberal accomplishments and thus discredit the intellectuals' attacks on the administration by demonstrating that they were based not on any substantive objection to its policies but on pure malice.

Moynihan's dislike of the left was, then, in no way a sign that he had become a conservative. Every policy he proposed to Nixon was a liberal one. Nixon greatly disliked the programs of the War on Poverty--Head Start, the Job Corps, community action--and also Model Cities, the other big Great Society program aimed specifically at the ghettos. "No increase in any poverty program until more evidence is in," he wrote Ehrlichman two months after taking office.

At the time, Moynihan was probably the War on Poverty's most visible critic, having published in 1969 a book attacking community action called Maximum Feasible Misunderstanding. And yet, in the first few months of the Nixon Administration, Moynihan succeeded in persuading Nixon not to open an immediate attack on the poverty programs. Why deliver the left any ammunition? "Avoid, at whatever immediate costs,...an enormous controversy over the 'war on poverty,'" he wrote Nixon a month after the inauguration, and in a new introduction to Maximum Feasible Misunderstanding written in early 1970 he proudly reported that all suspicions that Nixon harbored ill will toward the poverty programs had been shown to be nonsense. Moynihan pushed for budget increases for Model Cities, and distanced himself from his old Harvard friend Edward Banfield, who was academia's leading skeptic about the program.

PLAIN CASH

To Moynihan's mind, leaving the poverty programs alone was more a matter of political strategy than of policy-making, but Moynihan also had an ambitious plan for the direction in which social-welfare policy should move: toward a guaranteed annual income. Although he was strongly identified with jobs programs in the early sixties, and in the eighties has been best known as an advocate of work requirements for welfare recipients, he has not, strictly speaking, been inconsistent. He has always wanted the United States to become more like a Western European social democracy, with full employment and family allowances, but it is true that he has emphasized different parts of his views at different times. All through the late sixties the idea that a guaranteed income was the best way to fight poverty was his leading public cause. He and its other supporters argued that if poverty was defined simply as a lack of money, then a guaranteed income, even though for political reasons it could not be generous enough to take all families above the official poverty line, would certainly alleviate want among the poor.

Moynihan's idea had another great advantage: it would eliminate the middleman. Programs involving job training and education, and of course the community action program, created a large class of social workers. In the early sixties the planners of the War on Poverty used to refer to social workers as "Ladies Bountiful"--patronizing middle-class whites. After five years of the Great Society, though, the world of government social workers had changed considerably, to become the economic base of the black middle class: it was probably the locus in government of the kind of left-liberals that Moynihan and Nixon considered a threat to the stability of the country. If the government simply gave poor people money--adopted an income strategy instead of a services strategy, as Moynihan put it to Nixon--this would end the period of legitimizing, empowering, and enriching social activists, community organizers, civil-rights leaders, and the like. The social workers could hardly complain, because even as the government was cutting them out of the action, it would be passing the most sweeping anti-poverty program in history. They would be neutralized as a moral and political force.

To Nixon this was an attractive notion. He, too, disliked social workers. At the meeting where Moynihan proposed the Family Assistance Plan, when Moynihan said it would eliminate tens of thousands of social workers from the federal payroll, Nixon's eyes lit up. The idea that a vast hodgepodge of government social programs could be consolidated into one simple grant appealed to Nixon's practical, rationalizing side. He realized that spending had political uses that Republicans tended to be blind to. It was a lesson he had learned the hard way--"Ike should have spent more in '60," he told a group of aides a few months after taking office. At a time of instability, domestic government expenditures could have a calming effect ("He spent to keep the lid on," says Leonard Garment, who was Nixon's adviser on civil rights) and could buy him a little room to maneuver in his area of real interest, foreign affairs. Another of Nixon's advisers, Arthur Burns, a conservative economist who later became the chairman of the Federal Reserve Board, mounted a ferocious attack within the administration on the Family Assistance Plan, but by the spring of Nixon's first year in office Moynihan had beaten it back. In April, Nixon wrote Ehrlichman, "In confidence I have decided to go ahead on this program."

The Family Assistance Plan twice failed to pass in Congress, and since part of the opposition had been from the left, its failure only strengthened Moynihan's convictions. He wrote another book, The Politics of a Guaranteed Income, arguing, as he had about community action in Maximum Feasible Misunderstanding, that the left had become the main obstacle to the achievement of liberal goals in America. To his mind, the whole episode said more about the mood of the intellectuals than it did about the needs of the poor. In 1973, when he was the ambassador to India, Moynihan wrote Melvin Laird, who had taken over his portfolio at the White House, to urge a third try for the Family Assistance Plan.

It would not pass, Moynihan wrote, simply because "A guaranteed income will never be enacted while President Nixon is in office." But the fight was still worth it, because the plan was not "addressed to the poor"; it was "addressed to the cultural strata"--that is, it was meant to vitiate the arguments of intellectuals who liked to portray the Nixon Administration as heedlessly right-wing. Just proposing the Family Assistance Plan would help solve "the problem of legitimacy"--the present danger to authority in America--by providing a powerful rebuttal to the arguments of the dissenters.

By this time, though, Moynihan had lost Nixon. As a politician in office, Nixon could not afford to be as wholly consumed as Moynihan was with the thrust and parry of intellectual life. Anyway, the Family Assistance Plan was also unpopular with the right, especially the conservative Democrats and Republicans on the Senate Finance Committee, who considered it a plan to make welfare more generous and thus one that would encourage dependency. Moynihan believed that dependency was a problem, but he thought that there was no point in the Nixon Administration's addressing it, because the liberals would never allow it to be solved. A large welfare-dependent class will come to be accepted as the normal and manageable cost of doing urban business," he wrote Laird. "It is in ways a political subsidy, as irrational perhaps as those paid to owners of oil wells, wheat fields, or aerospace companies, but whoever said politics was rational? Not Melvin Laird!"

By the end of the summer of 1970 Ehrlichman was, his notes record, being told by Nixon, "Just get something done....Let it appear we've fought and come half way....Avoid appearance of defeat." It was particularly unfortunate for the Family Assistance Plan's standing with Nixon that George McGovern proposed a guaranteed income during his presidential campaign. At one point, discussing the McGovern plan with Ehrlichman, Nixon called in his faithful manservant, Manolo Sanchez. If McGovern won and implemented his plan, Sanchez said, according to Ehrlichman's notes, "I quit--go on welfare."

Although the Family Assistance Plan was never enacted, the record of the first Nixon Administration does look like a victory for the income strategy. Nixon acceded to congressional pressure to increase welfare, food stamps, Social Security, and disability pensions, and partly as a result government transfer payments to individuals rose much more during Nixon's presidency than they had during Johnson's, while growth in government social-welfare employment leveled off. In effect, the government began cutting off the route of escape from the ghettos that so many had used in the sixties: government jobs. Simply giving out money doesn't get people out. From the time Nixon took office, the black rate of exit from poverty slowed to a standstill.

Of all Nixon's domestic advisers, Moynihan had the clearest grasp of what was happening in black America. He saw that government jobs were expanding the black middle class at the same time that what we now call the underclass was being left behind in the ghettos. In March of 1969, in a long memo to Nixon, he stressed the need for "the integration into the larger society of what is now a sizable urban lower class which at the moment is experiencing more than its share of the bad habits and bad luck which through history have afflicted such groups and caused them to be seen as 'different' or undesirable by their more prudent and fortunate neighbors....The Negro lower class would appear to be unusually self-damaging, that is to say, more so than is normal for such groups."

With the underclass as with other social problems, Moynihan had two concerns: the problem itself, and the way left-liberal intellectuals (in this case, mostly black intellectuals) exploited the problem and so, he felt, damaged the American social fabric. This prevented him from being able to see the growth of the black government-employee class as a wholly sanguine development. As he wrote Nixon,

"The Negro poor having become more openly violent--especially in the form of the rioting of the mid 1960's--they have given the black middle class an incomparable weapon with which to threaten white America. This has been for many an altogether intoxicating experience. 'Do this or the cities will burn.' And of course they have been greatly encouraged in this course by white rhetoric of the Kerner Commission variety. But most important of all, the existence of a large marginal, if not dependent, black urban lower class has at last given the black middle class an opportunity to establish a secure and rewarding power base in American society--as the provider of social services to the black lower class....What building contracts and police graft were to the 19th-century urban Irish, the welfare department, Head Start programs, and Black Studies programs will be to the coming generation of Negroes. They are of course very wise in this respect. These are expanding areas of economic opportunity. By contrast, black business enterprise offers relatively little. In all this there will be the peculiar combination of weakness and strength that characterizes Negro Americans as a group at this time....There is no true Negro intellectual or academic class at this moment. (Thirty years ago there was: somehow it died out.) Negro books are poor stuff for the most part. Black studies are by and large made up of the worst kind of ethnic longings-for-a-glorious past...."

Helping the black ghetto poor, like other liberal goals, appealed to Moynihan both as something intrinsically good and as a gesture directed at the left. It would, he wrote Nixon, deprive "the militant middle class" of the ability to make an ongoing "threat to the larger society, much as the desperate bank robber threatens to drop the vial of nitroglycerin." Choosing an income strategy as the means to help the ghettos would palliate poor blacks' material needs without encouraging their integration into the larger society. It was the best possible course in terms of defanging the "militant middle class," but not in terms of the health of black America. Moynihan chose to make the intellectual gesture rather than pursue the most effective policy.

Perhaps to demonstrate the Nixon Administration's genuine concern about black poverty Moynihan arranged for a meeting in the White House, on May 13, 1969, between representatives of the Poor People's Campaign (led by Martin Luther King's former second-in-command, Ralph Abernathy, and also including Andrew Young and Jesse Jackson) and Nixon and several high-ranking members of the administration. The meeting was a disaster.

The group from the Poor People's Campaign arrived late. Abernathy opened the meeting by studying in its entirety a nine-page statement outlining a political program that would have struck everyone in the Nixon White House as wildly unrealistic. After Abernathy had finished, Nixon replied in a friendly but guarded and unspecific way, looked at his watch, and said that an urgent matter concerning the Vietnam War had come up and he would not be able to stay for the rest of the meeting. Abernathy asked him not to go yet and replied at length to what Nixon had said. After that Nixon did go, leaving behind Vice President Spiro Agnew and nearly half the Cabinet to be upbraided by several poor people Abernathy had brought with him. Then Agnew excused himself, but the meeting continued. After it had gone on for nearly three hours, Moynihan reported to the group that some poor people who had come to the White House with Abernathy and were waiting for him in another room were threatening to stage a demonstration. With that the meeting was adjourned. On leaving the White House, Abernathy told the television reporters outside that it had been "the most disappointing and the most fruitless of all the meetings we have had up to this time."

All this was far outside the accepted boundaries of White House meetings, and it was a blot on Moynihan's record: it was his meeting, he had failed to control it, and he had also failed to rise to Nixon's defense. Nixon "referred to that meeting for FOUR YEARS as the worst experience of his presidency," John Ehrlichman says. "When I'd bring up a meeting with black leaders, he'd say, 'You want me to have another meeting like that Moynihan meeting.'"

Moynihan lost his influence in the White House when he returned to Harvard at the end of 1970. In fact, it had largely ended before that, though Nixon continued to like him personally and kept communicating with him. Once Nixon had been re elected, there was no longer any need to outfox his critics by keeping the old poverty programs that they had expected him to gut. "Model Cities--flush it," Ehrlichman's notes record Nixon saying a few days after the 1972 election. A couple of weeks later, during a series of meetings with Ehrlichman to plan his second administration, he elaborated on the theme. Ehrlichman's notes of Nixon's directives include: "OEO- legal services [a program to provide the poor with lawyers, who sometimes sued local government on their behalf]. Sally Payton [a black lawyer on the White House staff]--tell her to screw it up"; "Take the heat on OEO--it's the right thing to do. Be prepared to take it head on"; and "Flush Model Cities and Great Society. It's failed. Do it, don't say it."

Even more than Nixon realized, a moment had passed in American history. Race remained, and will remain, one of the obsessive themes of American life, but the period when it was the central domestic concern of the federal government was over. Partly because the Democratic Party had embraced civil rights with fervor, the presidential electorate had become essentially Republican. Even among liberals, race now had to share the agenda with other issues, like environmentalism and feminism. Watergate would quickly end Nixon's ability to make any domestic policy at all, and more important, the OPEC Oil embargo would erase the national feeling that there was enough economic breathing space to allow for the contemplation of expensive social reforms.

At the same time that Nixon was dismantling the War on Poverty (after a long struggle, the OEO officially went out of existence in 1974), Lyndon Johnson was preparing for a big symposium on civil rights at the new LBJ Library, in Austin. Johnson was well aware that it was time for him to settle up the accounts--his heart had become very bad, and even in public he was constantly popping nitroglycerin pills to ease his angina pains. The library itself was finished, a typically Johnsonian overblown marble block. The civil-rights symposium was planned in a spirit of comity indicating that Johnson's soul was far more nearly at peace than it had been in 1967 and 1968, when (according to a memo Moynihan wrote to Nixon in early 1969) he was capable of a gesture like personally cutting from the federal budget the funds for a memorial to Robert Kennedy at Arlington Cemetery. Johnson delivered a smoking speech. He said that of all his work as President, civil rights "holds the most of myself within it and holds for me the most intimate meanings," and that "the black problem remains what it has always been, the simple problem of being black in a white society."

In January of 1973 Walter Heller, the economist who in 1963 had been the first person in the government to propose a government attack on poverty, had a speaking engagement at Johnson's alma mater, Southwest Texas State University and Johnson invited him to spend the night out at the LBJ Ranch. Heller, a self-controlled German, was amazed at how unwilling or unable Johnson was to change his way of life in deference to his health. Dinner was fried shrimp. The customary telephone was still at Johnson's side at the table, and was still ringing. A week later Johnson was dead.

The main subject of Johnson's disquisition at dinner was how deeply he cared about civil rights--how strong his record was, how it was his real legacy. Like many of the people who had worked for Johnson, Heller, while fond of him, was accustomed to wondering whether he really meant what he said or was just trying, in effect, to win a vote for that one last bill, the Lyndon Johnson Historical Greatness Act of 1979. Johnson was incapable of being simple and direct. He was always exaggerated, florid, calculating, vulgar. At one point in the review of his achievements he explained to Heller why he had appointed the black economist Andrew Brimmer to the Federal Reserve Board. "First I put Bob Weaver in the Cabinet," Heller remembered that Johnson said, referring to the first Secretary of Housing and Urban Development. "But they said, 'No, he's smooth-faced. We want somebody with"--and here Johnson pressed the corners of his mouth together with his two index fingers- "'FAT LIPS!' Well, nobody's got fatter lips than Andy."

Heller was shocked by this anecdote, but he left the ranch convinced that Johnson had been speaking from the heart about race relations. It is a tribute to Johnson that even though he simply could not come across in private as the conventional version of a distinguished statesman, and even though everyone who knew him well knew that he was regularly capable of insincerity, nobody--not Heller, not the civil-rights leaders he fought with, not the Robert Kennedy aides who maneuvered against him--doubted in the end that he was passionate about race relations. This was the public issue he cared about most, and as the years pass, it has become clear that he was the only President of this century who has cared about the issue so much. He told Heller that night, "I've done more for blacks than any other President. That young hero I replaced may have done something. But I did more." And he was right.


Copyright © 1989, Nicholas Lemann.
"The Unfinished War";
The Atlantic Monthly, January, 1989, issue., Volume 263, Number 1 (pages 53-68).
Sun, 12 Aug 2012 20:20:00 -0500 text/html https://www.theatlantic.com/past/docs/politics/poverty/lemunf2.htm
Killexams : 2021 Fast Company Brands That Matter

Patagonia Provisions and McDonald’s could not be more different as companies and brands. Yet in 2021 both have had an undeniable impact on business and culture, far beyond the products they sell.

When Provisions, the iconic outdoor apparel company’s food spin-off, launched Long Root Pale Ale beer, in 2016, it wasn’t trying to create the next Budweiser. The brew was merely the best way to devote more agricultural acreage to a perennial wheatgrass called Kernza, a regenerative crop that helps build soil health and sequester more carbon. The beer amplified Patagonia’s mission to fight the climate catastrophe and make it easier for others to join them.

COVID-19 led to greater food insecurity worldwide, and in response, more major corporations accelerated climate initiatives, particularly regenerative farming techniques, to fortify fragile food systems. In May 2020, Budweiser reported better-than-expected success in its initial efforts to reduce water usage as well as emissions in its rice production by using regenerative techniques, expanding its efforts to 2.7 million bushels. And in September 2020, the Nature Conservancy corralled Target, Cargill, and, yes, McDonald’s, to join a five-year program to Improve soil quality in Nebraska beef country. As Provisions director Birgit Cameron told Fast Company shortly after its Kernza initiative began, “If we can illustrate a path for the bigger companies to take, then we’ve won.”

Despite its global ubiquity, McDonald’s has rarely tapped the full cultural potential of its iconic status. Last year, though, the fast-food chain’s Famous Orders meal partnerships with such global music superstars as Travis Scott and BTS began changing that—creating a playbook for social media marketing, merchandise, and new music to push customers to the drive-through (where they can make TikToks of themselves ordering Famous Meals). “This has shown us this rabid fandom that exists if we can find the right ways to unlock it,” says Morgan Flatley, whom McDonald’s promoted to global CMO in August.

Whether it’s leading on the environment or pop culture, engaging B2B customers or responding meaningfully to current events, a brand’s ability to forge an emotional connection with consumers is critical in establishing a long-term relationship, enthusiastic loyalty, and advocacy. In our first-ever compendium of Brands That Matter, we recognize nearly 100 companies and nonprofits that deliver people compelling reasons to care about them—and offer inspiration for others to buy in.

Fri, 17 Jun 2022 05:56:00 -0500 en-US text/html https://www.fastcompany.com/brands-that-matter/2021
Killexams : CXO of the Week: Uthaman Bakthikrishnan, Executive Vice President of ClearTouch No result found, try new keyword!integration and automation, intelligence, reporting, and analytics. We provide a thorough grasp of contact center requirements together with a special pricing strategy that promotes quick ... Fri, 08 Jul 2022 00:17:00 -0500 text/html https://www.ciol.com/cxo-week-uthaman-bakthikrishnan-executive-vice-president-cleartouch/ Killexams : Screening and Treatment Program to Eliminate Hepatitis C in Egypt

Screening Targets

The Ministry of Health set goals to screen everyone in Egypt 18 years of age or older (a target population of 62.5 million) within 1 year and to provide treatment paid for by the state to all those with HCV viremia. Planning started in May 2018. The country was divided into three screening phases, each to be screened over a period of 2 or 3 months. Each phase included 7 to 11 states, 100 to 150 administrative divisions, and a screening target population of 17.9 million to 23.3 million, as detailed in the Supplementary Appendix (Table S2 and Fig. S2).

Screening Sites and Staff

Screening was conducted in all Ministry of Health hospitals; all primary and rural health units; Egyptian Health Insurance Organization–managed clinics, university hospitals, and military and police hospitals; and all youth centers in all screened areas. Mobile screening teams in specially outfitted vehicles augmented the screening efforts by visiting crowded areas on special occasions (mosques for Friday prayers, churches for Sunday mass, soccer stadiums during game times, and picnic areas and shopping malls on holidays), as well as factories, office buildings, train stations, and subway stations.

Each screening phase had 5800 to 8000 screening teams, each including a physician, a nurse, and a data-entry person. Screening sites were open 12 hours per day, 7 days per week. Training started 2 months before screening launch in each phase, in which 800 trainers were taught how to train the screening teams to use the rapid diagnostic test for the detection of HCV antibodies, to record data and results in the database, and to set further appointments electronically.

Tests and Prices

The World Health Organization (WHO)–approved rapid diagnostic test11 (SD Bioline HCV, Abbott) was used. Negotiations led to a price reduction to $0.58 per test, including the test kit, the safety lancet, and sharps-disposal containers; the cost also included supply-chain management and delivery to each of 380 central health facilities, which in turn distributed to the screening sites.

HCV RNA levels were measured with the use of a real-time quantitative polymerase-chain-reaction (PCR) assay (Cobas AmpliPrep/Cobas TaqMan HCV Test, Roche Diagnostics). Negotiations resulted in a cost of $4.80 per test, inclusive of the machines and logistics of setting up the machines, training the technicians, connecting the machines to the central database, and transferring the equipment from one phase to the next. PCR machines were set up in one to three laboratories in each state. Samples that were collected in the district referral hospitals were transported by the provider to the test laboratories.

Screening

Population data at the national, state, and district levels were obtained from the Central Agency for Public Mobilization and Statistics 2017 national census.12,13 The names and national identification numbers of persons 18 years of age or older who were registered in each electoral district were obtained from the National Elections Authority,14 which automatically registers everyone 18 years of age or older for voting in the district of his or her residence and has a comprehensive database of all persons 18 years of age or older.

Persons could be screened in any phase and any site, regardless of their residence. Participation in screening was voluntary, with no financial or in-kind incentives for participating and no punitive consequences for not participating. Participation in screening was encouraged and emphasized through a massive national advertisement campaign. Television advertisements ran on all channels throughout the screening period, several popular movie and music stars were contracted for the advertising campaign, and television and radio talk shows repeatedly had the national HCV screening program as their main theme. Newspaper advertisements and billboards on many roads were part of the advertising campaign, and millions of text messages were sent to cell phones in each phase.

Immediately before screening, the person’s national identification number was electronically checked against the NCCVH database (which includes data on patients previously treated for HCV infection with direct-acting antivirals since 2014). Patients who had been previously treated were not tested for HCV antibodies.

Persons were tested for HCV antibodies with the use of a finger-prick rapid diagnostic test, with results available within 20 minutes. Seropositive patients had appointments immediately scheduled electronically for a date within 2 to 15 days in the closest assigned center for evaluation and treatment. At the center, patients received clinical evaluation, underwent abdominal ultrasonography, and had blood drawn for HCV RNA and liver-function tests, as detailed in the Supplementary Appendix. Patients returned for results after 5 days, and treatment was prescribed for those with viremia. All patients were treated with sofosbuvir (400 mg daily) plus daclatasvir (60 mg daily) with or without ribavirin for a duration of 12 or 24 weeks, depending on the presence or absence of cirrhosis and the stage of cirrhosis. The time between screening and the dispensing of medication was usually 10 days but ran to 4 weeks for some patients who were delayed in scheduling or attending follow-up appointments. The shortest time to dispensing treatment was 6 days, and the longest time was 30 days.

Turnout for evaluation was continuously monitored. A call center contacted seropositive persons who did not show up for their evaluation appointments and patients with viremia who did not return for treatment, in order to inquire about reasons for no-shows and to assign new appointments if necessary.

Continuous political support from the Egyptian presidency helped make all necessary resources available. The WHO through its local office monitored the campaign as an independent verification agent.

Comparison with Previous Patients

Baseline characteristics and treatment outcomes of patients who were treated in this program were compared with those of patients presenting for treatment before this screening program.10 (Details are provided in the Methods section in the Supplementary Appendix.)

Cost Analysis

Total costs of the HCV components of the program were calculated to estimate costs of identifying a seropositive patient and a patient with viremia. Costs of cure per patient were also estimated.

Statistical Analysis

Details of data that were collected and analyzed are provided in the Supplementary Appendix. The following were calculated at country, state, and district levels: the percentage of persons in the target population who participated in screening and the prevalence of HCV seropositivity among persons screened for HCV antibodies. Confidence intervals for percentages were calculated with the use of the Wilson method in R software, version 3.6.1.

Results in each state and district were compared and analyzed according to sex, age group, and urban or rural residence. State-level prevalence was compared with that in the most latest nationwide survey, the 2015 DHS.7 Different geographic regions as detailed in Table S1 were compared. For patients with complete data, we analyzed data available as of September 30, 2019, regarding the outcome of evaluation of seropositive patients and the outcome of treatment (incidence of sustained virologic response at 12 weeks after completion of treatment).

All analyses were performed with the use of IBM SPSS Statistics for Windows, version 25.0. All tests of significance were two-sided, and a P value of less than 0.05 was considered to indicate statistical significance.

Wed, 05 Aug 2020 03:29:00 -0500 en text/html https://www.nejm.org/doi/full/10.1056/NEJMsr1912628
000-N01 exam dump and training guide direct download
Training Exams List